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Development of the prediction model for hypertension in patients with idiopathic inflammatory myopathies
Li Qin1, Yiwen Zhang1, Xiaoqian Yang1
1Department of Cardiology, The Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Sichuan, China.
Insights
A new prediction model helps identify patients with idiopathic inflammatory myopathies (IIMs) at risk for developing hypertension. Early detection and intervention can help manage cardiovascular risk in these patients.
Area of Science:
- Cardiology
- Rheumatology
- Epidemiology
Background:
- Cardiac involvement is a significant cause of morbidity and mortality in patients with idiopathic inflammatory myopathies (IIMs).
- Hypertension is a critical cardiovascular risk factor, yet its specific association with IIMs remains understudied.
- Understanding and predicting hypertension in IIMs is crucial for proactive cardiovascular care.
Purpose of the Study:
- To develop and validate a predictive model for incident hypertension in patients diagnosed with IIMs.
- To identify key predictors associated with the development of hypertension in this specific patient cohort.
- To provide a clinical tool for risk stratification and early intervention.
Main Methods:
- A retrospective cohort study involving 362 patients with IIMs was conducted between January 2008 and December 2018.
- Predictors for hypertension were identified using LASSO regression, multivariable logistic regression, and clinical relevance.
- A nomogram was constructed using selected predictors and validated through bootstrapping, C-index, calibration plots, and decision curve analysis.
Main Results:
- A total of 54 patients (14.9%) developed new-onset hypertension during the study period.
- The final prediction model incorporated predictors including age, diabetes mellitus, triglyceride levels, low-density lipoprotein-cholesterol (LDL-C), antinuclear antibodies (ANA), and smoking status.
- The model demonstrated good discrimination (C-index = 0.754) and calibration, with internal validation yielding a C-index of 0.728, indicating clinical usefulness.
Conclusions:
- A validated prediction model and nomogram can effectively assess the risk of developing hypertension in patients with IIMs.
- Early identification of high-risk individuals allows for timely implementation of preventive strategies.
- This tool supports clinicians in managing cardiovascular risk and improving outcomes for IIMs patients.
Abstract:
Cardiac involvement is an important cause of morbidity and mortality in patients with idiopathic inflammatory myopathies (IIMs). Hypertension, an important cardiovascular risk factor for the general population, has a crucial role in heart involvement. However, few studies have focused on the hypertension associated with IIMs. This study aimed to develop and assess the prediction model for incident hypertension in patients with IIMs. A retrospective cohort study was performed on 362 patients with IIMs, of whom 54 (14.9%) were given a diagnosis of new-onset hypertension from January 2008 to December 2018. The predictors of hypertension in IIMs were selected by least absolute shrinkage and selection operator (LASSO) regression, multivariable logistic regression, and clinically relevance, and then these predictors were used to draw the nomogram. Discrimination, calibration and clinical usefulness of the model were evaluated using the C-index, calibration plot, and decision curve analysis, respectively. The predicting model was validated by the bootstrapping validation. The nomogram mainly included predictors such as age, diabetes mellitus, triglyceride, low-density lipoprotein-cholesterol (LDL-C), antinuclear antibodies (ANA), and smoking. This prediction model demonstrated good discrimination with a C-index of 0.754 (95%CI, 0.684 to 0.824) and good calibration. The C-index of internal validation was 0.728, and decision curve analysis demonstrated that this nomogram was clinically useful. Clinicians can use this prediction model to assess the risk of hypertension in IIMs patients, and early preventive measures should be taken to reduce the incidence of hypertension in high-risk patients.
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